Delayed Onset Severe Dysphagia Due to Radiation Neuropathy -A Case Report
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A 37-year-old man visited outpatient clinic complaining of swallowing difficulty with weight loss. Twelve years ago, he received concurrent chemoradiotherapy on nasopharynx and neck due to nasopharyngeal cancer. There was no evidence of recent cancer recurrence in several imaging studies. Electromyography (EMG) demonstrated myokymic discharges in the cricothyroid, geniohyoid and genioglossus muscles. These findings suggested a delayed onset radiation-induced multiple cranial neuropathies. A videofluoroscopic swallowing study (VFSS) revealed severe oropharyngeal dysphagia and oroesophageal tube feeding was started. He has been followed up for 1 month but there has been no significant improvement in swallowing function in VFSS. Nevertheless he benefited from using appropriate maneuvers with VFSS and obtained proper nutrition. In this case, performing a VFSS was critical in making a proper clinical decision. A VFSS, in addition to EMG, might be considered as one of the essential tests in patients who went through concurrent chemoradiotherapy (CCRT) for nasopharyngeal cancer. (JKDS 2013;3:32-35)
Abstract
A 37-year-old man visited outpatient clinic complaining of swallowing difficulty with weight loss. Twelve years ago, he received concurrent chemoradiotherapy on nasopharynx and neck due to nasopharyngeal cancer. There was no evidence of recent cancer recurrence in several imaging studies. Electromyography (EMG) demonstrated myokymic discharges in the cricothyroid, geniohyoid and genioglossus muscles. These findings suggested a delayed onset radiation-induced multiple cranial neuropathies. A videofluoroscopic swallowing study (VFSS) revealed severe oropharyngeal dysphagia and oroesophageal tube feeding was started. He has been followed up for 1 month but there has been no significant improvement in swallowing function in VFSS. Nevertheless he benefited from using appropriate maneuvers with VFSS and obtained proper nutrition. In this case, performing a VFSS was critical in making a proper clinical decision. A VFSS, in addition to EMG, might be considered as one of the essential tests in patients who went through concurrent chemoradiotherapy (CCRT) for nasopharyngeal cancer. (JKDS 2013;3:32-35)
참고문헌 (9)
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